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NPI Code Detail

MEDICARE: DR. GWENDOLYN ROSE CABRERA DPT

MEDICARE:  DR. GWENDOLYN ROSE CABRERA  DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282N00000XGeneral Acute Care Hospital

General Provider Information

NPI Number : 1467553644
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GWENDOLYN ROSE CABRERA DPT
Provider Business Mailing Address
First Line : 3818 CLAYTON AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90027-4720
Country : US
Telephone Number : 213-453-4867
Fax Number :
Provider Business Practice Location Address
First Line : 11301 WILSHIRE BLVD
Second Line : BUILDING 500, ROOM 1454
City : LOS ANGELES
State : CA
Zip : 90073-1003
Country : US
Telephone Number : 310-478-3711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2006
Last Update Date : 07/08/2007

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Directions to “ DR. GWENDOLYN ROSE CABRERA DPT” Practice Location

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